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Keloids are excessive accumulations of scar tissue beyond the original boundaries of the wound. This distinguishes them from thickened scars which still keep to the wound's original boundary. Keloids typically retain their pinkness, and are often itchy and tender. Scars and keloids do not usually cause medical problems, but they are unsightly and unappealing from an aesthetic point of view.
Following
a large deep wound to the skin both skin cells and connective tissue cells
(fibroblasts) begin multiplying to repair the damage. The fibroblasts
form a framework upon which the skin cells can migrate into and fill in
the wound. It is the balance between the rate of replication of fibroblasts
versus skin cells that is important. If the fibroblasts replicate too
quickly, they can form a dense network that is not as easily penetrated
by the skin cells and that results in a large scar. If the skin cells
keep up with the fibroblasts, then little scar tissue is formed and the
skin has a more normal appearance after the wound has healed. Minor scars
occur more readily in older people because their skin cells replicate
more slowly and fill in the wound less well than in younger people.
A Report on Computerised Integration of Multimodality Imaging in Scar
Assessment from (name of publication) by; Bernard Cena, Department of
Computer Science, University of Western Australia; Bruce Backman Occupational
Therapy, Royal Perth Hospital; Kris Booth, Occupational Therapy, Royal
Perth Hospital; Fiona Wood, Department of Surgery, University of Western
Australia.
The scar is the final result of an injury. It is the sum of the injury
and all subsequent interventions on the way to healing. The quality of
the scar determines the quality of life of the patient. Scar quality assessment
is thus a vital part of injury management. It allows monitoring of results
of intervention methods and their comparison. Such assessment should be
as objective as possible, eliminating subjective bias. The scar is a complex
structure, abnormal in its colour, depth, contour and pliability. It is
a difficult task to quantify all these characteristics in a consistent
and meaningful manner.
One assessment method that attempts to combine these attributes is the
Vancouver General Hospital (VGH) index. It relies on subjective assessment
of scar features using short, non-equal interval scales and a final score
based on these scales. To achieve objective scar quality assessment, measures
of scar attributes are needed and a means to combine those measures. We
propose that by building a three-dimensional (3D) image of the scar and
mapping of scar attribute data in this framework provides a basis for
developing an objective scar quality assessment system. This paper presents
the initial experiments with acquiring a 3D image of the scar with conventional
medical ultrasound imaging equipment.
an instrument. Surgical knot; an extra loop in the first throw prevents the
knot slipping while it is being tied. Granny knot; not used because it slips!
however a square knot tied on top of it prevents this
What are stitches made of?
It is likely that several differant materials have been used to close you up. Silk; soft, easy to use and ties well. However it provokes a strong inflammatory reaction because it is a foreign protein and may also act as a focus for infection. Nylon; similar to fishing line. It causes very little tissue reaction but it is tricky to handle and the knots slip easily.
However it is very strong and permanent as it is not absorbed. Often used on the skin because the lack of tissue reaction minimises scarring. When used in one long invisible stitch just under the skin the two ends are often secured with clips or beads instead of knots.
Cat gut; is no longer made from cats! However it is still made from a natural material so that it is absorbed and can therefore be used under the skin in the fat and other layers so that no trace is left after a week or two. The famous 18th century surgeon John Hunter invented a way of pickling cat gut with chromic acid, the technique is still used today, and 'chromic gut' is a common suture material, it is absorbed more slowly than plain gutkeeping its strength for longer.
Steel; stainless steel is used in places where strength is most important such as the breast bone after heart surgery. It can be used in a staple gun which is speedy to use. Other common sites are bowel surgery and skin closure. Glue; super glue sticks skin fast. As no needles are used it is painless, so it is often used for small wounds on children.
Some differant sorts of stitching used by surgeons:
Single; common in skin closure, a series of individual stitches make simple loops through the flesh.
Mattress; each individual stitch makes a double turn closing the tissue under the skin as well.
Subcuticular; the stitch runs continuously in a zig zag within the skin, leaves the neatest scar. Continous; like a running stitch, speedy to use.
Numbers of scars generated by NHS surgery in 1985:
The total number of operations was 2,214,490 of which neck & thyroid 16,580 mastectomy 36,630 appendix 51,230 other abdomenal 230,970 inguinal hernias 64,600 hysterectomy 66,470 hip 36,700
Other causes of scars include:
Accidents on the roads in 1993 in Great Britain (Deaths 3,814) serious 45,009 minor 257,000 Non fatal accidents at home attending A/E and requiring admission to hospital in 1993:146,000
It
is likely that several differant materials have been used to close you
up. Silk; soft, easy to use and ties well. However it provokes a strong
inflammatory reaction because it is a foreign protein and may also act
as a focus for infection.
Nylon; similar to fishing line. It causes very little tissue reaction
but it is tricky to handle and the knots slip easily. However it is very
strong and permanent as it is not absorbed. Often used on the skin because
the lack of tissue reaction minimises scarring. When used in one long
invisible stitch just under the skin the two ends are often secured with
clips or beads instead of knots.
Cat gut; is no longer made from cats! However it is still made from a
natural material so that it is absorbed and can therefore be used under
the skin in the fat and other layers so that no trace is left after a
week or two. The famous 18th century surgeon John Hunter invented a way
of pickling cat gut with chromic acid, the technique is still used today,
and 'chromic gut' is a common suture material, it is absorbed more slowly
than plain gut keeping its strength for longer.
Steel; stainless steel is used in places where strength is most important
such as the breast bone after heart surgery. It can be used in a staple
gun which is speedy to use. Other common sites are bowel surgery and skin
closure. Glue; super glue sticks skin fast. As no needles are used it
is painless, so it is often used for small wounds on children.
The total number of operations was 2,214,490 of which neck & thyroid 16,580 mastectomy 36,630 appendix 51,230 other abdomenal 230,970 inguinal hernias 64,600 hysterectomy 66,470 hip 36,700 Other causes of scars include: Accidents on the roads in 1993 in Great britain (Deaths 3,814) serious 45,009 minor 257,000 Non fatal accidents at home attending A/E and requiring admission to hospital in 1993:146,000